Provider Demographics
NPI:1790372829
Name:MAHMOOD, SARA JABEEN (FNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JABEEN
Last Name:MAHMOOD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2497 POINTE COUPEE
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-4389
Mailing Address - Country:US
Mailing Address - Phone:909-287-9377
Mailing Address - Fax:
Practice Address - Street 1:2497 POINTE COUPEE
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-4389
Practice Address - Country:US
Practice Address - Phone:909-287-9377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF95016130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily